Medical advise tumor lipoma

[Nnaibaff88]

Dear all,

 

my my girlfriend was diagnosed a tumor in her left groin, 8x8 cm. We went to Siriraj hospital to do the CT scan and the doctor said it’s most likely a Lipoma. Does anyone here ever had this kind of surgery done in Bangkok? Siriraj hospital quoted us 400k THB for the removal. Since my girlfriend recently resigned and was about to start her new job in November the insurance will not pay for it. My opinion is that if it needs to be done it will be done of course. But at the same time I’m wondering if this is a common price for such a procedure?

 

i would appreciate any insights.

thanks.

[nikmar]

missis had a  lipoma tumour on her wrist. A private hospital wanted to charge the earth. She went to a Government hospital played the waiting game and got it done for around 7000 bt...inc. 1 night in hospital. She had waited years to get it done after finding out it was benign, as she was terrified of going under the knife so it had grown to a reasonable size. Good job as well, not much of a scar etc.

[nikmar]

actually it could have been cheaper, ive just asked her and she thinks around 5000 bt

[Nnaibaff88]

Thanks mate. The waiting game is what we can’t afford since she has to start her new job asap. ????

[nikmar]

hop eall goes well for you both. ????

 

[lopburi3]

You are sure that 400k was what the hospital told you?  Perhaps they tried to translate and got it wrong?  Most such fat deposits are not even removed but hard for me to believe that much at any hospital.  Would assume area involved would not affect work so unless painful perhaps best not to rush things.  

[Sheryl]

That is a very high price indeed, even for what is  an unusually large lipoma.

 

Was this the Siriraj private wing? (Must have been! But high even for there).

 

Are you 100% sure it was 400k and not 40K? As the latter would be more usual for something like this at Siriraj. 400K is what one would likely pay for a cardiac bypass in Siriraj private wing so really difficult to imagine how it could be 400k to remove a lipoma, even a large one and even if located quite deep.

 

There is no hurry in taking out  a lipoma, in fact does not even have to come out if that is what it is --  but the issue is to be certain of that and can't be until it is removed and biopsied.

 

When you talk about insurance are you referring to Social Security? Because even after resigning, if she had been under it for a year she can maintain it by paying the premiums herself. In any case, if she is about to start a new job she will again have it through that and can get it done then at whatever hospital she registers under. I am assuming this is SS and not private insurance, that tends to be only for teachers at private schools. If she is a teacher at a private school then it is more complex as it likely is private insurance rather than SS and usually a pretty poor policy with ridiculously low coverage level.

 

If it is the latter rather than SS, then I suggest she consult a general surgeon at either:

 

St Louis Hospital on Sathorn

Camellian Hospital on Thonglor

Mission Hospital - near Rajdamnoen

 

All 3 are non profit private hospitals and usually similiar in price. Something like 100k would be what I would expect price wise at those, a bit more if done laparoscopically instead of open (if that is an option).  That much even a private school insurance policy should cover. (I am assuming that as group insurance policy pre-existing conditions will nto be excluded, but check to be sure)

 

If it is SS then she will have to have it done at the hospital she registers at and she will get a list of the options when she starts work. Pre-existing is nto an issue under SS.

 

 

[Nnaibaff88]

Thank you very much for your replies. I should have mentioned that my gf is Thai so price of 400k is correct. BTW the CT scan cost 20k and yes it was the ‘private wing’ since we wanted to avoid waiting long time. They said it’s complicated to remove and will take about 3-4 hours and two doctors. Also I’m referring to social security.

 

The doctor from Siriraj said we must not wait more than one month. Overall I found the doctor quite pushing us. From reading the internet and from your reply it seems we would have time.

 

Also, we only found out about it because she had to do the health checkup for the new company (international Pharma giant). She has no pain whatsoever. Although you can feel the lipoma easily and even see it.

[Sheryl]

The only urgency would be the risk of it being something other than a lipoma.

 

There is a rare form of cancer called liposarcoma which can look a lot like a deep lipoma.

 

If she has a liposarcoma, as opposed to a lipoma, then indeed it needs to be removed as soon as possible.

 

Is it possible they were saying liposarcoma not lipoma?  Or lipoma vs liposarcoma? Actually from CT alone I do not think the distinction can be made, they would have to biopsy it. It sounds like what they were suggesting was to do excision and biopsy in a single procedure but an initial  needle aspiration biopsy might be an option (depending on how accessible the lesion is, but at that size one would think they could get at it)  and would tell you which it is,  which in turn would inform how much urgency.

 

From what you are describing now - very deep and going to take 2 surgeons 3-4 hours to excise, which suggests it is tightly fixed to adjacent structures -- sounds potentially suspicious for liposarcoma.

 

When exactly did she resign from her prior job? She can maintain her SS cover between jobs by paying the premium directly and if it has been not more than a month there may still be time to do this. Otherwise there will be about a 1 month waiting period after she starts her new job. She can contact the SSO for info on how to maintain her coverage by self pay in the interim. That will keep her eligible for care at whatever her prior SS hospital was until she enrolls elsewhere.

 

If it is too late to maintain her SS, one option now that you have the CT done would be to switch over to the public channel at Siriraj. Costs there will be much less and if there is truly a suspicion of liposarcoma they will expedite scheduling of her surgery.

 

If you have not yet, get a copy of the CT report and post it here with the name and hospital number blocked out.

 

 

[Nnaibaff88]

Also the doctor said that veins are running through it that’s why they can’t do a ‘needle aspiration biopsy’. 

[Nnaibaff88]

We don’t have a CT copy. They didn’t hand it to us (is that usual?) and we didn’t ask since we were somewhat under shock.

[Sheryl]

You can easily get it, and you'll need to have all the records anyhow if getting treated elsewhere.

 

Just call the call center and tell them she'll be coming in for them. She just shows her ID at the medical record section. There may be a small charge for the photocopying. Re the CT ask for the actual CD as well as the report.

 

You might want to consider having a follow up consultation with the doctor at the same time, now that the shock has settled somewhat and you have some more specific questions to ask i.e. might this actually be  a liposarcoma?  I think the answer is yes, at least possibly and this is why they urged operating sooner rather than later. Siriraj is a very good hospital and I have not known them to push unnecessary procedures or unnecessary haste even in their private wing.

 

Other questions to ask:

 

  - how to go about getting this done through the regular public wing, what it would cost, how long a likely wait

 

- specific background needed for surgeons to operate on this, in case she ends up having it done elsewhere e.g. at SS hospital. For example, is it necessary to involve a vascular surgeon or just a general surgeon?  There are very large blood vessels in the groin area and it sounds like the tumor may have to be dissected from those vessels which if so, is indeed tricky.

 

In the discussion explain frankly that you do not have this sort of money and she has SS coverage elsewhere.